The patient was admitted with a bleeding rectum. After a complete medical evaluation at Fortis Hospital Shalimar Bagh, under Dr. Pradeep Jain, Director, GI Cancer and his team, Arun Kumar was diagnosed with advanced colon cancer.

Due to multiple complications, the patient had to be stabilised in the Intensive Care Unit (ICU) for over 40 days before his treatment could begin. The patient underwent chemotherapy and radiation therapy, after which he was discharged from the hospital. Apparently, within 15 days, Kumar had to be re-admitted as he had fever, chills and breathlessness. A cardio assessment revealed that the patient had a very low rate of pumping heart power – 30% against the average rate of 60%. His oxygen supply was also very low and he had to be put onto ventilator support.

His kidney function test also showed irregularities and the ultrasound report revealed presence of fluids, swelling in the lungs and an increase in the size of the liver. Besides that the patient had an active infection and stones in the gall bladder and bile duct as well. The stones were removed through an endoscopic procedure, post which stenting was done. Once the infection had been controlled and the patient stabilised, he underwent a laparoscopic cancer surgery. However due to the extremely low rate of heart power – the surgery proved to be immensely challenging. His blood pressure, pulse rate, oxygen saturation and CO2 levels had to be constantly monitored, maintained and kept in check during the surgery.

Dr. Jain and Dr. Umesh Deshmukh, Head of Department, Anesthesia, Fortis Hospital, Shalimar Bagh successfully conducted the laparoscopic surgery. No complications arose during the post-operative period and he was discharged within a week. Considering the complications that had arisen before the surgery, Kumar had recovered well and in good time.

Dr. Pradeep Jain

Dr. Jain, said: “This case was extremely challenging as the patient was diagnosed with multiple morbidities. He was brought to the hospital in an extremely critical state and was kept in the ICU in excess of 40 days. Kumar had to be stabilised so that we could proceed with the laparoscopic surgery for colon cancer. These complications in surgery could have been avoided if the disease had been diagnosed at an early stage. Therefore, it is essential for everyone to get screened periodically and regularly. If any symptoms such as change in bowel habits (diarrhea, constipation or stool consistency), rectal bleeding, blood in stool, abdominal pain, cramps, bloating, discomfort, unexplained weight loss, unexplained anaemia, it should not be ignored but immediately evaluated medically.”

Elated about his recovery, Kumar said: “I had been bleeding from rectum for over two years and considered the condition as piles as all my previous doctors diagnosed it as piles. It was at a much later stage that I was diagnosed with colon cancer. While I was in ICU, I was very critical and my family wasn’t hopeful of my survival. However, Dr. Jain and his team did not give up and continued to work relentlessly on making me better, treating one condition at a time. It is because of their efforts that I am healthy today and am able perform my regular day to day activities with ease.”

Mahipal Singh Bhanot, Facility Director said: “This was one of the most challenging cases as the patient suffered from multiple life-threatening complications. Stabilising the patient was the main focus for the doctors. However, this was successfully achieved due to the diligence with which the case was handled. This case was a unique example of smooth coordination and team work between the various teams.”

Third most common cancer

Colorectal Cancer has the lowest incidence in India in contrast with Western Countries. However, it has seen a rise in numbers with the increasing urbanisation in India. According to a report by the Indian Council of Medical Research (ICMR), colorectal cancer is the third most common cancer in men and the second most common in women. In India, the annual incidence for colon cancer in men is 4.4 per 100000 and 3.9 per 100000 in women.

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